The relationships between socioeconomic position (SEP), COVID-19 Mortality (CM), and chronicity are well established. SEP is inversely associated with chronicity that in turn is directly associated with CM. Our goal is to analyze the mediated effect of SEP on CM attributable to chronicity.
We gathered information on all 331,938 SARS-CoV-2 infections from 50+ year-olds in the Lazio Region from Feb/2020 to Feb/2022. We used the Italian deprivation index at the neighborhood level as measure of SEP and all-cause mortality within 30 days from a positive test as CM. We ran sex-stratified and age-adjusted mediation analyses using the product method, reporting total effects, natural indirect effects, the mediation proportion (MP), and their 95% Confidence Intervals (95%CI).
Although lower SEP had both higher prevalence for every chronicity and higher CM, the Natural Indirect Effects were statistically significant but negligible. Hypertension had the highest MP for both males (MP: 9.6%, 95%CI: 5.1-14.1) and females (MP: 9.9%, 95%CI: 5.1-14.8).
We found significant but low MP for most chronicity under analysis, indicating that the majority of inequalities in CM do not come from inequalities in chronicity.